Employee must complete immediately following knowledge of injury or illness and submit to University Corporation HR.
This form, along with DWC1, must be completed, signed, returned to University Corporation HR within 24 hr of injury.Online timecard system (ADP)
Use only if exemptions are different from Federal and/or additional amount is to be deducted from State taxes.
As of Jan 1, 2018 the IRS mileage reimbursement rate increased to 0.545. Please use Travel Expense Claim 2017 for mileage incurred prior to Dec 31, 2017 and Travel Expense Claim 2018 for mileage incurred after Jan 1, 2018.